Heartburn May Follow Barrett's Esophagus

DR. PAUL DONOHUE GOOD HEALTH

Dear Dr. Donohue: What is Barrett's esophagus? I have had a hiatal hernia for many years with no problems. -- J.R.

Dear J.R: Have you had heartburn? Many dismiss it as "no problem," but it can have serious consequences, one of which is Barrett's esophagus.

Stomach juices and acid were meant to stay in the stomach. The stomach is built to cope with those corrosive liquids. The esophagus is not protected from digestive juices. When they squirt up into the esophagus, heartburn results. The backup of digestive juices is called GERD -- gastroesophageal reflux disease. It can happen with a hiatal hernia or without one. Heartburn is the Rodney Dangerfield of digestive ailments. It gets no respect. But it should.

In a few heartburn patients, the lining of the esophagus undergoes a transformation that makes the esophagus's features resemble those of the lower parts of the digestive tract. That transformation constitutes a Barrett's esophagus. Barrett's esophagus can be a prelude to cancer.

Control of heartburn with medicine eliminates heartburn pain. It does not, however, cause Barrett's esophagus to revert back to normal. Scope examinations of the esophagus must be scheduled at regular intervals to detect any cancerous changes.

Experimentally, wiping out Barrett's tissue with lasers, cautery or light and eliminating stomach acid production seem to change Barrett's tissue back to normal esophageal tissue. Time will tell if this treatment holds up and becomes standard practice.

Dear Dr. Donohue: What are the options for treating hammertoe? -- K.G.

Dear K.G: When the toe joint between the tip of the toe and the toe attachment to the foot bends upward, the condition is called hammertoe. The nail -- end of the toe turns downward.

The tendon to the involved toe is too tight. Rarely do stretching exercises loosen the tendon, but you can try them. Put about 20 marbles on the floor and try picking each up with the toes. That stretches tendons. So does using the toes to crumple a towel spread out on the floor.